What are public lice?

Public lice are tiny parasites that inhabit the thick hair near the genitals. They are often referred to as crabs because of their crab-like appearance. These lice survive by feeding on human blood. 

Unlike head lice or body lice, pubic lice specifically inhabit the hair in the pubic region and are not found on the scalp or other parts of the skin. However, they can also be found in other areas in the body with thicker hair such as:

• Underarm hair

• Facial hairs like beards or mustaches

• Chest hair

• Eyebrows and eyelashes (which is more common in children)

Pubic lice spread through close physical contact, most often during sexual activity when hair comes into direct contact with someone else’s infested hair. Although less common, sharing items like towels or bed linens with an infected person can also lead to transmission. 

Treatment usually involves the use of medical shampoos or creams that kill both the lice and their eggs. These treatments can be purchased without a prescription or prescribed by a doctor.

Are pubic lice considered a sexually transmitted infection? 

Pubic lice are frequently associated with sexually transmitted infections because they are most commonly spread through sexual contact. However, pubic lice themselves are not classified as a disease or infection. They can also be transmitted through nonsexual means. 

Are pubic lice considered a disease?

Pubc lice do not transmit or cause any diseases, so they won’t make you ill. However, they can cause significant itching and discomfort. Excessive scratching may damage the skin, creating an opening for bacteria to enter and potentially lead to a bacterial infection.

Do many people get Pubic lice?

Public lice are fairly common and can affect individuals worldwide, no matter their race or ethnicity. They are most frequently seen in adults. 

What are the common symptoms of having pubic lice?

Signs of a pubic lice infestation usually appear within about five days. Common symptoms include:

• Intense itching in areas with coarse hair, especially around the genitals.

• Mild fever and a general feeling of fatigue or discomfort.

• Tiny white nits (eggs) attached to pubic hairs that are difficult to remove

• Light blue or grayish spots on the thighs, lower stomach, or buttocks

• Tiny black particles (lice waste) in your underwear

• Redness or small spots of bleeding on the skin caused by lice bites

What causes the itching from pubic lice?

Public lice bite the skin to feed on blood. These tiny bites trigger an allergic response in the body, which leads to the intense itching.

In what ways are pubic lice transmitted?

Pubic lice are transmitted through close physical contact with someone who is infested. The lice move from one person’s pubic hair to another’s. The most common way to contract crab is through sexual activity with an infected partner. However, any intimate skin-to-skin contact can spread these lice, even without intercourse or penetration. 

In some cases, crabs can also be spread by sharing or coming into contact with contaminated clothing, bedding, or towels from an infected person. That said, casual interactions like shaking hands or hugging are unlikely to transmit crabs.

What is the appearance of pubic lice?

Pubic lice are tiny insects that you might be able to spot if you carefully examine your pubic hair. They are called “crabs” because their appearance resembles small crabs found by the ocean. Sometimes, you might even notice them moving around. 

Their appearance changes as they grow:

• Nits: these are the eggs of the lice, very small and often difficult to see. They are typically oval shaped and can be yellow, white, or pearly in color. Nits are firmly attached to the base of hair shafts, right where the hair emerges from the skin. They usually take six to ten days to hatch.

• Nymphs: After hatching, the young lice are called nymphs. They look like smaller versions of the adults and need about two to three weeks to reach full maturity.

• Adults: Mature lice have six legs, with the font pair being larger and shaped somewhat like crab pincers. Adult lice are generally tan or grayish-white and measure roughly 1.1 to 1.6 millimetres about the size of a pencil tip. Both nymphs and adults survive by feeding on human blood, and they can only live up to 72 hours once they are off the human body. 

Is it possible to catch pubic lice from an animal?

No, pubic lice are not transmitted by dogs, cats, or other animals. 

Are pubic lice identical to head lice?

No, they are different. The lice that infest the scalp and body are distinct from pubic lice. Pubic lice typically do not live in the hair on your head.

Can children become infested with pubic lice?

Yes, children can contract pubic lice, especially if they share a bed or towels with an infected person. In kids, these lice are more commonly found on the eyelashes or eyebrows. The presence of pubic lice in a child could also be an indicator of posible sexual abuse and should be taken seriously.

Is it possible to catch crabs from using the same toilet seat as someone who has them?

It’s unlikely that you would contract crabs from sharing a toilet seat with an infected person. Pubic lice cannot survive long without being on a human host, and they are unable to grip onto smooth surfaces like toilet seats. 

What are the signs that indicate I might have pubic lice?

You might be able to spot the lice themselves, although they are very tiny and not always easy to notice. Seeing them is the most reliable way to confirm an infestation. Pubic lice are about the size of a pinhead and resemble small grayish crabs.

How does a healthcare provider determine if I have pubic lice?

Sometimes, you might experience signs of pubic lice without actually seeing the lice themselves. If you’re uncertain, it’s important to visit a healthcare provider for an accurate diagnosis. They might use tools like a magnifying glass or microscope to detect the lice. If pubic lice are found, your provider may also suggest screening for other sexually transmitted infections.

What treatments are effective for eliminating pubic lice?

Pubic lice are treated with specialized shampoo or creams designed for the affected areas. Regular soap and hot water won’t eliminate the lice. These products can usually be purchased without a prescription and are safe and effective as long as you follow the instructions properly. Be sure to carefully follow the instructions provided on the product label.

To get the best results, follow these steps:

• If lice are still present after treatment, repeat the process after nine to ten days.

• Avoid using insecticides on clothing or household items

• Refrain from sexual activity until the infestation has completely cleared, which usually takes about two weeks.

• Wash clothing, bedding, and towels in hot water and dry them on a high heat setting to kill any lice.

• For items that can’t be washed, seal them in a plastic bag for two weeks or take them to a professional cleaner.

• Change into clean clothes and underwear after treatment.

• Remove any lice eggs (nits) from hair by carefully combining or picking them out with your fingers or tweezers.

• Leave the product on for the recommended amount of time before rinsing it off.

• Inspect for lice in all hairy areas, including underarms and other parts of the body, and wash thoroughly.

• Apply the treatment cream or shampoo to all potentially infested areas such as the thighs, underarms, lower abdomen, buttocks, and around the rectal area. Avoid using the product on eyelashes.

It’s important that anyone you live with or have had sexual contact with in the past two months also receives treatment to prevent re-infection.

What kinds of medicated shampoos and creams are used to treat pubic lice?

Non-prescription treatments for pubic lice are available and include several effective options: 

• Permethrin cream -  this is applied directly to the infested area and rinsed off after about 10 minutes.

• Pyrethrin combined with piperonyl butoxide - a medicated shampoo that’s applied to the affected area and also washed off after 10 minutes.

Are there medical treatments for pubic lice that require a prescription? 

If non-prescription treatments aren’t effective, your doctor may recommend stronger, prescription-based options. These can include medicated creams, shampoos, or oral medications.

Oral treatments, like ivermectin, are taken in pill form and work by killing lice after they feed on your blood. Typically, two doses are required for full effectiveness. 

Malathion is a prescription topical lotion applied directly to the affected area. It’s usually left on for up to 12 hours before being washed off. 

Another powerful option is lindane shampoo, which targets both lice and their eggs. However, due to the risk of serious side effects, including potential harm to the brain and nervous system, lindane is generally only used if other treatments haven’t worked.

Management of lice and nits on eyelashes or eyebrows

You shouldn’t use the same lice treatment near your eyes that you would on your pubic area, as it could be harmful. It might be possible to gently remove lice or nits from your eyelashes or eyebrows using a fine comb or your fingers. If this method isn't effective, your healthcare provider can prescribe a special cream that is safe for use around your eyes. This treatment usually requires applying the cream to your eyelids multiple times daily for as long as 10 days.

Can I try different home treatments for pubic lice?

Medicated shampoos or creams specifically designed for lice are the only effective ways to eliminate pubic lice. These products work by killing the lice directly. Shaving the area or taking hot baths will not get rid of the infestation. While a hydrocortisone cream can help relieve itching, it actually treats or removes the lice. 

Can I apply pubic lice medication if I am pregnant or nursing?

If you are pregnant or nursing, consult your doctor or healthcare provider before starting any lice treatment.

Do my sexual partner (s) need treatment for pubic lice? 

Contact any sexual partners you’ve had in the last two months, as they might be also infected with pubic lice and require treatment.

Can shaving eliminate pubic lice?

No, using a razor to shave your pubic region does not effectively treat or eliminate pubic lice.

Do pubic lice pose any health risks?

Public lice generally do not lead to serious health issues. The most common symptoms are itching and irritation. However, excessive scratching can sometimes result in a secondary bacterial infection.

What is the typical duration for treating pubic lice?

Treatment for pubic lice typically lasts around two weeks. If the infestation remains, a second round of treatment might be necessary to fully eliminate the lice. 

Is it possible to get pubic lice again after being treated?

Yes, it’s possible to become infected with pubic lice again after treatment. To reduce the risk of reinfestation, it’s important to follow preventive steps and avoid close contact with someone who has lice.

What steps can I take to avoid getting pubic lice?

The best way to prevent pubic lice is to avoid close physical contact with anyone who is infected. However, there are practical steps you can take to reduce your chances of getting crabs and to stop them from coming back:

Do:

• Complete the full course of treatment and confirm that the lice are gone before resuming sexual activity.

• Wash clothes, bedding, and towels thoroughly with hot water.

• Ensure that any sexual partner who has had pubic lice gets treated. 

• Don’t share personal items such as clothing or towels.

• Limit the number of sexual partners you have, and try to avoid sexual contact with individuals who have multiple partners.

Don’t

• Share towels, bedding, or clothing with a person who has pubic lice.

• Try on bathing suits without underwear when shopping; if you must try them on, wear underwear underneath.

• Use insecticide sprays as they are not effective against pubic lice and may be harmful. 

• Engage in sexual or close physical contact with someone who is infected.

Keep in mind, individuals with other STIs may be more vulnerable to pubic lice. Practicing safe sex by using condoms is important, but condoms do not provide protection against pubic lice.

Is it safe to use pubic lice shampoo as a preventive measure?

If you learn that a recent sexual partner from the last month has pubic lice, it’s okay to use a lice shampoo or cream as a precautionary measure. 

Can taking regular showers stop pubic lice?

Contracting pubic lice is not related to personal cleanliness. Pubic lice are spread through close physical or sexual contact with someone who is already infested.

When is it safe to have sex again?

Hold off on any sexual activity until you and your partner (s) have completed the full course of treatment. Make sure the lice are completely gone before resuming sex, which may take up to two weeks. 

When is it necessary to consult a doctor?

Consult a doctor if you suspect you have pubic lice. In many cases, non-prescription treatments are enough to eliminate the lice. However, if those don’t work, your provider might recommend a more effective, prescription-based option. 

Which questions are important to address with my healthcare provider?

If you think or know you have pubic lice (crabs), here are some questions you can ask your healthcare provider:

• What ‘s the best option to get rid of pubic lice?

• How often do I need to apply the treatment, and for how long?

• When is it safe to start having sex again?

• Do I need to inform any sexual partner(s) about the infection?

• What steps can I take to avoid pubic lice again?

• Are there any possible long-term effects or complications from having crabs?